The role of cardiotocography in predicting perinatal outcomes in women presenting with reduced perception of fetal movements at term: an observational study

Authors

  • Bhuvaneshwari K. M. Department of Obstetrics and Gynecology, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India
  • Rekha N. Department of Obstetrics and Gynecology, BGS Global Institute of Medical Sciences, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20234080

Keywords:

CTG, NST, Perinatal outcome, Reduced fetal movements

Abstract

Background: Reduced perception of fetal movement by mother is a common reason for self referral for assessment by healthcare providers affecting 5-15% of pregnancy. It allows early identification of fetuses at risk of adverse outcome. Non stress test (NST) or Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum fetal surveillance. Hence, this study was conducted to evaluate the role of NST/CTG in predicting perinatal outcomes in women presenting with reduced perception of fetal movements.

Methods: A prospective observational study was conducted on 110 term pregnant women presenting with reduced perception of fetal movements. NST/CTG was done as a preliminary test in them and the results were analyzed statistically.

Results: Total 60% women had reactive CTG, 17.3% had suspicious CTG and 22.7% had pathological CTG at the time of presentation. Out of 66 women who had reactive NST, 34 women were discharged after observation for 24 hours to follow up. About 58.15% women had one or more risk factors associated with pregnancy in our study. Pathological/ suspicious CTG was more commonly associated with adverse perinatal outcomes like presence of MSAF, low APGAR score at 1 minute and 5 minutes, neonatal distress, need for neonatal resuscitation and NICU admission with statistical significance. However, all babies had good outcome in our study.

Conclusions: Early approach, timely intervention could reduce associated complications and improve perinatal outcome in all these cases.

 

References

Cunningham FG, Leveno K, Dashe J, Hoffman B, Spong C, Casey B. Williams Obstetrics 25e. 25th ed. New York, NY: McGraw-Hill Education; 2018:331.

Patrick J, Campbell K, Carmichael L, Natale R, Richardson B. Patterns of gross fetal body movements over 24-hour observation intervals during the last 10 weeks of pregnancy. Am J Obstet Gynecol. 1982;142(4):363-71.

Dhungana PR, Adhikari R, Pageni PR, Koirala A. Decreased fetal movement: Is it an alarm to obstetrician and pregnant lady? Med J PokharaAcad Health Sci. 2018;1(2):92–7.

Mccarthy CM, Meaney S, Donoghue O. Perinatal outcomes of reduced fetal 8 movements: a cohort study. BMC Pregnancy Childbirth. 2016;16(1).

Saastad E, Vangen S, Frøen F. Suboptimal care in stillbirths-a retrospective 34 audit study. Acta Obstet Gynecol Scand. 2007;86(4):444-50.

Saastad E, Winje BA, Pedersen S, Frøen B. Fetal movement counting improved 2 identification of fetal growth restriction and perinatal outcomes - a multi-centre, randomized, controlled trial. Belizan JM, editor. PLoS ONE. 2011;6(12).

Whitworth M, Fisher M, Heazel A. Reduced Fetal Movements Green-top Guideline No. 57. 2017;57.

Freeman RK. Antepartum testing in patients with hypertensive disorders in pregnancy. Semin Perinatol. 2008;32(4):271-3.

Neogi M, Kumar Lahiri T, Biswas B, Bag T, Kumar Mistri P, Bhadra A. A study of antepartum cardiotocography in mothers with reduced fetal movement at term and its correlation with fetal outcome. Clinical Practice. 2019;38(8):30.

Syeda RM, Shakuntala PN, Rao SR. Fetal outcome in pregnant women with 23 reduced fetal movements. Int J Health Sci Res. 2013;3(7):18-28.

Gangwal M. The correlation between foetal movements count and foetal outcome. Int J Med Biomed Stud. 2019;3(12).

Salma U, Jabeen M, Shimul S, Akhter D. Analysis of cardiotocography findings in pregnancy with less fetal movement and its association with perinatal outcome. Med Today. 2018;30(1):19-22.

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Published

2023-12-29

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Original Research Articles